Elaborado con IA a partir del resumen de los autores
Editorial que sintetiza una colección especial de 2024 sobre la psiconeuroenendocrinología de los trastornos psicóticos, con énfasis en el papel de factores hormonales en su etiopatología. Reúne cinco estudios que examinan la relación entre función tiroidea y síntomas psicóticos en esquizofrenia, el impacto de neuropéptidos circulantes en cognición y esquizofrenia, el papel del estrés psicosocial en biomarcadores del líquido cefalorraquídeo en psicosis de primer episodio, y cambios hormonales en trastornos psicóticos perinatales. Destaca hallazgos clave: reducción de neuropéptidos (hormona estimulante de melanocitos, neurotensina, orexina-A, oxitocina, sustancia P) en trastornos mentales graves; asociación entre estrés psicosocial y biomarcadores del líquido cefalorraquídeo; rol emergente de la glándula tiroidea en estructura y función cerebral en esquizofrenia temprana; e incertidumbre sobre la influencia hormonal en cognición en psicosis perinatal.
Puntos clave
La función tiroidea muestra relaciones significativas con mecanismos biológicos estructurales y funcionales y síntomas clínicos en psicosis y esquizofrenia.
Neuropéptidos circulantes como oxitocina y sustancia P actúan como biomarcadores transdiagnósticos potenciales de enfermedad mental grave y correlacionan con severidad de síntomas psicóticos.
El estrés psicosocial modera la asociación entre biomarcadores del líquido cefalorraquídeo y la duración del período no tratado en psicosis de primer episodio.
Cambios hormonales perinatales en dopamina, cortisol y función tiroidea se asocian con trastornos psicóticos, aunque el vínculo con disfunción cognitiva permanece incierto.
Para quién: Estudiantes, docentes e investigadores de psicología clínica, psicopatología y neurobiología interesados en comprender los mecanismos neuroendocrinos de la psicosis y esquizofrenia como base para diagnóstico y tratamiento.
Resumen de los autores
The aim of this research topic was to present the most recent and relevant advances in our understanding of the role of hormonal factors implicated in the etiopathology of psychotic disorders. Five studies are included in this issue. Two explore relationships between thyroid function, structural and functional biological mechanisms, and clinical symptoms of psychosis and schizophrenia (Frontiers | Case report: Impact of hyperthyroidism on psychotic symptoms in schizophrenia comorbid with Graves' disease (frontiersin.org); Frontiers | Relationship between thyroid-stimulating hormone, BDNF levels, and hippocampal volume in antipsychotic-naïve first-episode psychosis patients (frontiersin.org)). One study investigates the impact of circulating neuropeptides on cognitive function and symptoms in schizophrenia and related disorders (Frontiers | Decreased plasma neuropeptides in first-episode schizophrenia, bipolar disorder, major depressive disorder: associations with clinical symptoms and cognitive function (frontiersin.org)). The concept of stress is closely allied with endocrinological disruption. show α-MSH, neurotensin, orexin-A, oxytocin, and substance P to be decreased in all three patient 66 groups compared to the control group. Lower oxytocin levels and higher substance P levels in this 67 study were associated with higher severity of psychotic symptoms in schizophrenia as well as bipolar 68 disorder. β-endorphin was found to be correlated with early morning wakening in all patient groups. 69Plasma neuropeptides were consequently identified as potentially important transdiagnostic 70 biomarkers of severe mental illness. 71 While there are many forms of stress, psychosocial stress is often not investigated in 72 biological studies focusing on cerebrospinal fluid (CSF). Following up on the gaps in this field, Giné-73Servén and collaborators (Frontiers | Psychosocial stress moderates the relationship between 74 cerebrospinal fluid lactate dehydrogenase and the duration of untreated psychosis in first-episode 75 psychosis (frontiersin.org)) investigated whether psychosocial events mediate/moderate the 76 association between duration of untreated psychosis (DUP), lactate dehydrogenase levels in CSF and 77 other CSF biomarkers in FEP patients. Among 95 individuals with FEP, 56.8% reported a stressful 78 life event in the previous 6 months. In these, a shorter DUP correlated with LDH concentrations after 79 adjustment for potential confounding factors. The suggestion is that psychosocial stress modulates 80 the association between CSF biomarkers and the onset of psychosis. 81 Palacios-Hernández and collaborators (Frontiers Hormones, psychotic disorders, and 82 cognition in perinatal women: a mini review (frontiersin.org)) provide a review of hormonal changes 83 influencing the onset of perinatal psychotic disorders as well as cognitive dysfunction in perinatal 84 women. Fourteen studies are included in the review, that mainly tested the following five hypotheses: 85 1) change in dopamine receptors, 2) increase in cortisol levels, 3) change in estrogen levels, 4) 86 determination of thyroid dysfunction and 5) decrease in oxytocin levels. Only one reported studied 87 the relationship of hormones and cognition. Evidence for three of the examined hypotheses in the 88 review is found: 1) increased dopaminergic response was related to high sensitivity of hypothalamic 89 receptors, 2) elevated cortisol levels were seen, in line with the neural diathesis-stress model of 90 psychosis, and 3) a relationship was seen between thyroid dysfunction and psychotic episodes. There 91 was no relationship between hormones and cognitive function. 92To sum up what there is to learn in this special Frontiers issue investigating endocrinological 93 effects on psychosis in 2024, we emphasize the emergent role of the thyroid gland on brain structure 94 and function in patients with early schizophrenia (5). We learn that neuropeptides, though not 95 identical to substances generally considered as hormones, are important inter-cellular signaling 96 molecules whose levels differ significantly between patients with severe mental illness and controls 97 as a result of psychosocial stress. Lastly, with regard to perinatal psychotic disorder in which a 98 relationship between hormones and psychotic symptoms has been previously shown, we learn that 99 the question of hormonal influence on cognition in this disorder remains understudied and uncertain. 100
González-Rodríguez, A., Cullen, A. E., Cullen, A. E., & Seeman, M. V. (2024). Editorial: Psychoneuroendocrinology of psychosis disorders, volume II.Frontiers in Psychiatry. https://doi.org/10.3389/fpsyt.2024.1398841
